Spinal glomus AVM presenting solely with groin pain: illustrative case

Abstract

BACKGROUND Spinal glomus arteriovenous malformations (AVMs) are rare and can cause neurological morbidity due to spinal hemorrhage, venous hypertension, or mass effect. OBSERVATIONS The authors presented a rare case of spinal glomus AVM presenting with groin pain due to nerve root compression by a feeder aneurysm. A 41-year-old woman was referred to the hospital with initial right groin pain that had worsened over 2 months. Magnetic resonance imaging showed intra- and extramedullary abnormal flow voids at the T11–12 level, and spinal angiography revealed an intramedullary AVM, with extramedullary protrusion of an aneurysm on the feeder vessel, which arose from the sulcal artery of the anterior spinal artery. Because compression of the right L1 nerve root by the aneurysm was the likely cause of the patient’s pain, endovascular embolization was performed. The feeder aneurysm disappeared after partial n-butyl 2-cyanoacrylate embolization, and the groin pain disappeared immediately after treatment. Her clinical status has been stable with no recurrence during 1 year of follow-up. LESSONS This is the first report of glomus-type AVM presenting with radiculopathy alone. One should not overlook the possibility of spinal AVM among patients with groin pain.